Day 12
- Join ward round at postnatal ward (1 Topaz) with registrar, Mo and Ho.
-Study about how to document post operation review after labor.
-Join USM students class "Bed site teaching" with the topic PROM.
-In the labor room:
* Observe normal delivery and examine the placenta either complete or not.
*prepare pitocon 40cc after delivery uterine contraction.
-Join oncall at labor room from 9.30 pm till 4.00am.
Take home message taken:
1) - NRC (next review contraction) done every 2hours.
- NRVE (next review vaginal examination) check every 4 hours.
2) Before doing placental removal do uterine massage until feel the uterus is globular.
3signs of placental separation:
-Gush of blood
-lengthening of cord
-uterus hard & globular
3) Before delivery, pitocin 40unit in normal saline to stimulate uterine contractions.
One bottle contain 10cc pitocin, must use 4 bottle 40cc pitocin into normal saline.
4)after delivery of placenta, check the:
-cotyledon must all present
-2 membrane
-chorion and amnion
-vessels (2 arteries one vein)
Then put in plastic, timbang and put into the paper bag with name of mother and NRC no.
5) after delivery, inject syntocinon IM at mother's thigh to stimulate uterine contraction to prevent PPH.
6) In active phase of labor, do urinary catherization to drain the urine because full bladder can make delivery process lengthen.
7) For mother, during delivery, dont lift the buttock if not tear may happen.
8) After do ARM (use amniohook) , tick on CTG paper where is the point of ARM.
Amniohook
9) Learn how to plot partogram with USM students.
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